Private health insurance is a drag on the economy
Insurance is enough to make you sick
Private health insurance is a drag on the economy the government must fix.
By Patt Morrison
Los Angeles Times
January 4, 2007
It’s a good thing I have health insurance, because I thought my ticker was going to give out when I read this: Health insurance companies will not sell policies, at any price, to hale and healthy people who have, or had, some pretty trifling ailments. Hemorrhoids. Varicose veins.
A woman who’d gone to a psychologist after breaking up with her honey was denied. So was a guy with jock itch, and a 40-year-old man with asthma.
Lisa Girion’s front-page Times article the last day of 2006 leaped off the page and grabbed me by the throat, which is pretty much what health insurers are doing to millions of Americans — strangling them. If they don’t work for a company with health benefits and they want individual health policies, they pay huge premiums for skimpy benefits, if they can get a policy at all. For health insurers, it’s a seller’s market, and they ain’t selling.
Business, which has a firm grip on the legislative joystick, hits the panic button at talk of single-payer healthcare or universal healthcare, and it hauls out its own boogeyman phrases, such as “job-killer” and “drag on the economy.”
I’ll tell you what’s a drag on the economy. Healthcare insurance that’s impossibly expensive, or impossible to get. If the United States wants a vital economy of personal enterprise and risk-taking, then it needs to guarantee health coverage, period. Americans are willing to take chances in business and careers, but not with their families’ health, or their own.
Dan Luke is an Oregon insurance broker. He told me that he runs into this “all the time — people staying in jobs they don’t like. People have dreams about going into business for themselves that they can’t fulfill because they don’t want to lose medical coverage, and they can’t pay a lot of money for [individual policies] even if they are healthy.”
I gave him a professional for instance: Say there’s a man who wants to switch careers, start something on his own. He’s 59, married, four kids, comes to you for health insurance. He smokes cigars. (“Mmmmm,” I heard Luke say.) And he had heart-valve surgery almost 10 years ago.
Luke stopped me right there. The man would never get coverage. I didn’t even get to ask Luke about the risk factors of riding motorcycles and skiing.
My “for instance” is Arnold Schwarzenegger. If the governor weren’t a rich man, if he were just a guy with a bold idea who wanted to give it a shot, as Schwarzenegger did when he abandoned acting for governing, he couldn’t get health insurance. He’d be stuck in his old job instead of bringing something new to the economy and to his life.
A 2004 health industry survey Girion cited said 12% of applicants for individual policies were turned down. Luke believes it’s closer to 40%. “I can’t think of any other business,” he said, “where people have money in their hand to buy a product, and you can’t sell it to them.”
Schwarzenegger — on crutches because of his broken leg — gives his State of the State speech Tuesday. In October, at a meeting at The Times, I asked him what he’d do in a new term, and what he said then is what, it turns out, he’ll be promoting next week: “Find a way of providing healthcare for the people of California.” Now, with screws and cables holding his leg together, he can contemplate the pickle he’d be in if he were just Arnie S., a desk jockey dreaming of making something more of himself — and uninsurable at any price.
http://www.latimes.com/news/printedition/opinion/la-oe-morrison4jan04,1,2915046.column?coll=la-news-comment
And…
Kaiser to push for standards on health plans
The move comes amid a growing controversy over the insurance industry’s cancellation of individual policies for medical coverage.
By Lisa Girion
Los Angeles Times
January 3, 2007
Kaiser Foundation Health Plan Inc. said Tuesday that it was working with state regulators to develop standards to protect its members from unfair cancellations of health insurance, a move that the state’s largest HMO hopes could lead to industrywide reforms.
Kaiser’s move comes as it was being fined $100,000 by state regulators for dropping a policyholder it accused of concealing his epilepsy when he applied for coverage, even though the condition had never been diagnosed by a physician.
Also, the policyholder was unaware of his seizures because they were accompanied by amnesia.
Oakland-based Kaiser said its proposed standards would include the requirement that it consult with policyholders before deciding whether to rescind their coverage. Such a consultation would help the HMO determine whether policyholders intentionally submitted inaccurate information about their health conditions in order to obtain coverage.
Other health plans, including Blue Cross of California and its rival Blue Shield, are fighting regulators and former policyholders for the right to rescind coverage when medical information relevant to the policy-granting decision is left out of an application — even if the omission is an honest mistake or the result of a foggy memory or poorly worded question.
Amy Dobberteen, enforcement chief for the Department of Managed Health Care, said Kaiser’s plan to talk to policyholders first was a shift in the right direction.
“Other plans have pointed out to us endlessly that that’s not required by law,” Dobberteen said. “For goodness sake, if you are consumer-friendly, why wouldn’t you contact the consumer? … A health plan does have the moral responsibility to pursue [this information] when they are about to wipe out from under them their entire health security blanket.”
Cindy Ehnes, director of the managed care agency, has called a Jan. 29 hearing in Los Angeles to gather suggestions for regulations she is developing that would clarify the law and enhance consumer protections against unfair cancellations.
http://www.latimes.com/business/la-fi-kaiser3jan03,1,417514,full.story?coll=la-headlines-business
Comment:
By Don McCanne, MD
The first step in problem solving is to define the problem.
Let’s see. Hundreds of thousands or even millions of people nationally are denied health insurance coverage because of their prior medical histories, even for trivial disorders. That seems like a problem.
So what solution is California considering? They are attempting to establish specific guidelines for the insurers in order to protect them from penalties when they rescind coverage for individuals who successfully negotiated their underwriting process, but then obtained care for injuries or illnesses often unrelated to any preexisting problem.
What?! We do have real problems in health care. Let’s address those!
Protecting and nurturing the private insurers should be the very last priority of our public stewards, especially since the private insurers have continued to refuse to protect and nurture those with health care needs.
The private insurers are the greatest problem in health care financing today. Let’s throw them out and establish our own public single payer system. That would benefit the health of all of us. Oh, and our economy too!